1. Compassion Fatigue: How to Self Care When You Can't Give Any More Gary U. Behrman, PhD, M.Div. MSW, LCSW

2. COMPASSION FATIGUE How to Self Care When You Can't Give Any More

3. OBJECTIVES  Recognize our bio-psycho-social-spiritual needs as Partnering in Care  Identify what it means to be Healthy  Understand three types of Stress  Develop strategies to enhance Resilience

4. RESILIENCE The ability of a person to withstand a significant amount of change in her/his life

5. Resilience the capacity to exhibit resourcefulness by using available internal and external resources in response to different contextual and developmental changes

6. COMPASSION “cum passio:” to suffer with Empathy: the ability to listen to & understand what the other person is experiencing

7. JUST LISTEN The courage to simply sit with the person at a time of pain and uncertainty cannot be underestimated.

8. Resilience as a Holistic Approach  Biological: My physical health  Psychological: My emotional health  Social: My relationships  Spiritual: My purpose & meaning in life

9. BIOLOGICAL  MOVE! Studies have shown over & over again, health & resilience depend upon bodily movement  How much movement do you get each day?  Stretching?Exercise?Biking?  Walking?Dancing?Climbing a tree? All it takes is owning a pair of tennis shoes

10. PSYCHOLOGICAL  What is the 1st emotion you felt this morning?  Do you time how long your emotions last?  Don’t strive to be happy, impossible!  Experience the wonderful range of emotions

11. SOCIAL  How are my relationships? Who needs my attention? Loose Threads? Unintended conflicts? Who’s on my mind?

12. SPIRITUAL Strive for purpose & meaning in life What brings joy to my life today? Why am I still here on this planet? What is most meaningful to me today?

13. Religion  Religion is the tool box that teaches HOW TO BE SPIRITUAL Not all people find religion helpful for this

14. Knowing the Connections  What are the connections between: Resilience & Change? Stress & Change? Health & Change? Strengths & Change?

15. STRESS!!!  What is stress: ANY reaction to CHANGE  Physical, emotional, social, spiritual

16. Towards the End of Life  Many changes going on Biological Psychological Social Spiritual This can create STRESS for everyone

17.  Types of Stress D – Stress D – Stress O – Stress O – Stress U - Stress U - Stress

18. Living in the Zone  D Stress: too much change  O Stress: too little change  U Stress: right amount of change for me

19. Managing Change  How effective am I at managing CHANGE? Name one significant change in your life since working in long term care How does your body react when thinking of this change? What emotion surfaces when you think of this? How is this change affecting your relationships? How is this impacting the meaning of your life?

20. Factors that Contribute to Stress 1. Condition of your body 2. The span of your emotions 3. The quality of your relationships 4. The meaning of your life Who or What needs to change? Could be one or all four…

21. Strengths-based Approach

22. Avoid looking only for what is wrong with you  Strengths-based definition: “All people must be seen in light of their capacities, talents, competencies, possibilities, vision, values and hope, however dashed and distorted these may have become through circumstance, oppression or trauma”

23. Definition of Health “ The overall optimal functioning of a person according to that person’s capacity at a particular moment in time”

24. “FRAIL NURSING HOME RESIDENT” What if we measured HEALTH in terms of a person’s spirituality?

25. Strengths Based Approach  Identify and optimize your strengths  Recognize your strengths to mobilize your resources  Identify “possibilities versus problems”  Emphasize capacity building  Promote religious & cultural strengths  What’s working for you today?

26. Serenity Prayer Grant me:  The serenity to accept the things I cannot change  The courage to change the things I can  And the wisdom to know the difference

27. SERENE “calm, peaceful, and untroubled; tranquil.” List a moment in time where you felt this:  Where were you? How old were you?

28. COURAGE “mental or moral strength to persevere, and withstand danger, fear, or difficulty” List a time in your life that you were courageous  Where were you, how old were you?

29. WISDOM “the ability to understand life, common sense or judgment; or knowing what to overlook”  Name a person who you experience as wise  What characteristics make him/her wise

30. Predictors of Health Your ability to: Your ability to:  Adapt to change = resilience  Maximize available resources  Stay physically active  Create options & choices  Maintain satisfying relationships  Move from Care-giver to “Partners in Care”

31. Partners in Care as a Strength Bio: Opportunity to be active Psycho: Empathy for others in their situations Social: Rewarding relationships with others Spiritual: Renewed inner meaning & purpose

32. Building Partnerships  From Care-Giving to Partnering in Care Focusing & building on strengths in yourself, your team, and your patients Focusing & building on strengths in yourself, your team, and your patients Framing partnering as a collaboration among many sources of strength Framing partnering as a collaboration among many sources of strength

33. Partnering in Care is a “Career Partnering in Care is a “Career ”  A career involves: Ongoing development of new knowledge, skills and values Ongoing development of new knowledge, skills and values Being able to change our lifestyle with the demands of the “job” Being able to change our lifestyle with the demands of the “job” Being flexible with numerous changes Being flexible with numerous changes Partnerships – building key relationships is key to creating a successful career Partnerships – building key relationships is key to creating a successful career

34. Partnering in Care  Partnering in care is essential—includes many relationships  As partnering increases, competency increases  Ask for help & accept limitations and refer

35. Partnering in Care Which health care environment is RIGHT for you? Asking a squirrel to excel in water does not produce great results How do we find our tree?

36. Partnering in Care  Bio-Psycho-Social-Spiritual approach: Eating well: fresh fruits and vegetables Eating well: fresh fruits and vegetables Engaging in regular aerobic movement Engaging in regular aerobic movement Challenging mental tasks Challenging mental tasks Enhancing your capacity for empathy Enhancing your capacity for empathy Building relationships Building relationships Creating a meaningful life Creating a meaningful life

37. TAKE HOME MESSAGES

38. REMEMBER  Partnering in Care is complex—one size does not fit all families  Build relationships & resources!  Ongoing strengths-based self- assessment  Re-frame care-giving as a partnering “opportunity” to enhance your health

39. REMEMBER  Focus upon: Identifying your greatest strengths Identifying your greatest strengths Utilizing bio-psycho-social-spiritual Utilizing bio-psycho-social-spiritual Practicing asking for & receiving help Practicing asking for & receiving help Learning how to create partnerships Learning how to create partnerships Focusing on what is most meaningful Focusing on what is most meaningful

40. REMEMBER  Change is inevitable  Managing change is key to health  Resilient persons embrace change  Know how much change is healthy for you  Take a nap!

41. Partnering in Care is Sweet!

42. Resources  Family Caregiver Alliance (National Center on Care-giving) www.caregiving.org  National Family Caregiver’s Association http://www.nfcacares.org / http://www.nfcacares.org /  Partnerships in Motion: A Renaissance in Aging www.partnershipsinmotion.com. www.partnershipsinmotion.com  Berg-Weger, Rubio, Tebb (2001) Strengths-Based Practice With Family Caregivers of the Chronically Ill: Families in Society: The Journal of Contemporary Social Services. Vol 96(3)  Berg-Weger, Rubio, Tebb (2000) Care Giving Well Being Scale. Health & Social Work. Volume: 25 Source Issue: 4